Individual
JOSEPH PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
914 S SCHEUBER RD, CENTRALIA, WA 98531-9027
(360) 736-2803
Mailing address
2940 W MARINE VIEW DR, EVERETT, WA 98201-3926
(425) 258-7014
(425) 258-7760
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00018900
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1784107
—
WA
Enumeration date
12/14/2006
Last updated
07/08/2007
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